Provider Demographics
NPI:1346553070
Name:TENEYCKE, TRICIA L (PSYD, LMHC, ATR-BC)
Entity Type:Individual
Prefix:DR
First Name:TRICIA
Middle Name:L
Last Name:TENEYCKE
Suffix:
Gender:F
Credentials:PSYD, LMHC, ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:509 OLIVE WAY STE 1025
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-1710
Mailing Address - Country:US
Mailing Address - Phone:206-387-5544
Mailing Address - Fax:
Practice Address - Street 1:509 OLIVE WAY STE 1025
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-1710
Practice Address - Country:US
Practice Address - Phone:206-387-5544
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-22
Last Update Date:2022-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY60410848103TC0700X
WALH00009170101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA00009170OtherSTATE LICENSE